Pre-Registration

Upstate Neurosurgery Welcomes You to Pre-Registration!

By utilizing the Pre-Registration process, new patients can register their demographic and billing information with a Pre-Registration staff member prior to their scheduled appointments. Patients are encouraged to pre-register in order to simplify the check-in process on the day of the appointment.

Please complete this form at least 3 business days prior to your appointment, if possible. If you have any questions, please call 315-464-4470 or 1-800-255-5011 (toll free.)

Pre-Register Online

This is a multiple-page form. Please click on Submit/Continue to Next Page after you complete each page. On the last page, please click on Submit All to finish the pre-registration process. You can print a copy of the completed form at the end of the session.

You will be asked to provide information such as your name, address, employer, primary care/referral physician and insurance. Please have the information ready before you start. Completion of this form may take about 10-30 minutes depending on your situation.

For your protection, the transmission of your submitted data is encrypted. Please read the disclaimer (this will open a new window) before you proceed.